4417 (1) 1 ??? 2 ??? BEC 22 BOROUGH OF BECKENHAM REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1955 BY L. R. L. EDWARDS, M.D. (Lond.), D.P.H. Medical Officer of Health BOROUGH OF BECKFNHAM REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1955 BY L. R. L. EDWARDS, M.D. (Lond.), D.P.H. Medical Officer of Health MEMBERS OF THE PUBLIC HEALTH COMMITTEE YEAR 1955 Chairman: Councillor L. E. MacCallum, M.C. Deputy Chairman: Councillor R. J. Butcher. Alderman C. P. Christie. Alderman R. S. Jackson. Councillor H. E. W. Botting. Councillor C. M. Hamilton. Councillor R. G. Cook. Councillor G. E. Fish. Councillor D. R. Knox-Johnson. Councillor E. R. Smithers. Councillor A. C. Garrett. Councillor C. B. Curtis, M.B.E. Councillor E. J. Porter. Councillor Mrs. D. E. L. West. Ex-Officio: The Mayor. STAFF OF THE PUBLIC HEALTH DEPARTMENT Medical Officer of Health L. R. L. Edwards, M.D. (Lond.), D.P.H. Chief Sanitary Inspector G. A. Webber, Certificate of the Royal Sanitary Institute and the Sanitary Inspectors' Examination Joint Board. Certificated Food Inspector. Deputy Chief Sanitary Inspector E. U. Williams, Cert. R.S.I, and S.I.E.J.B. Certificated Food Inspector. District Sanitary Inspectors W. T. G. Woodard, Cert. R.S.I. and S.I.E.J.B. Certificated Food Inspector. K. J. Coppin, Cert. R.S.I, and S.I.E.J.B. Certificated Food Inspector. H. R. Dawkins, Cert. R.S.I, and S.I.E.J.B., Cert. Inst. Hsg. (Resigned 22/5/55.) J. A. Keen, Cert. R.S.I, and S.I.E.J.B. Certificated Food Inspector. (Appointed 26/9/55.) T. P. Jarrett, Cert. R.S.I, and S.I.E.J.B. (Appointed 26/9/55.) Clerical Staff: Secretarial Assistant Mrs. E. A. Best. Clerks Miss C. Mawbey. Miss A. Keen. Mrs. A. Macrory (Resigned 28/1/55.) Miss H. Lomas (Appointed 21/2/55) Rodent Operators W. J. E. Wickenden. E. J. Read. Disinfector-General Assistant J. G. Freeland (Appointed 16/12/54—Resigned 18/3/55). F. Jarvest (Appointed 19/4/55— Resigned 28/10/55). M. Hindson (Appointed, Oct., 1955). Mortuary Attendant—General Assistant A. L. Jarvis. 3 CONTENTS page Introductory Letter 5 Vital Statistics 11 Total Deaths 1955 12 Cancer Deaths 13 Infantile Mortality 14 Vital Statistics for years 1947 to 1955 15 Infectious Diseases: (1) Ten-Year Trend Graphs 16 (2) Acute Infections 18 (3) Tuberculosis 21 Mass Miniature Radiography 22 Chest Clinic 23 Tuberculosis Care Committee 24 Women's Voluntary Service 24 Care of Old Persons, Old Peoples Welfare Committee 26 National Assistance Act 26 Vaccination and Immunisation 26 Morbidity Returns 27 Health Services, including Hospitals and Nursing Homes 28 Clinics for Maternity and Child Welfare 30 Report of the Chief Sanitary Inspector 31 4 INTRODUCTION To the Chairman and Members of the Public Health Committee. I HAVE the honour to present my report on the health of the Borough during 1955. Vital Statistics. Though births showed a decrease of 39, there was an increase of 60 in the civilian population. There is, therefore, a slow increase in Beckenham again of the floating population which commenced in 1953 following a decrease of 730 in the preceding three years. Since that date there have been increases of 160 and 60 respectively. There was a marked fall in the infant mortality rate and again no maternal deaths were recorded. All rates except the birth-rate remain better than the national average. A great proportion of the deaths of babies under one week old were due to Prematurity. This year the number was five out of six deaths, compared with the usual ratio of 50 per cent. Deaths from Cancer of the Lung were less this year. During the past five years there were three times as many deaths from this disease as from pulmonary tuberculosis. Since 1950, 156 Beckenham residents—five times as many men as women—have died from this disease. Of all deaths from malignant growths in men, cancer of the lung accounted for one-third. The cause of this disease remains still an open one. Until the preponderance of the disease in men rather than women, which varies little over the years, can be confidently explained, one cannot accept any of the theories propounded. Indeed, it is not certain that the cause we seek is one still active, or was active years ago, and if the latter, how many years ago? There were half as many deaths this year from accidental causes. In view of the high proportion of elderly persons and children in the borough, this fact should be rewarding to those members concerned with Road Safety, Homes and Accident Prevention. Infectious Diseases. There were 976 cases of Measles, the third highest figure in the last 10 years. Though usually February and March are the months for Measles, last year the greatest number occurred in December. A sharp fall in the holiday months and the absence of cases to the end of the year was more like the behaviour of this disease in Beckenham. Only one case was admitted to hospital and there were no deaths. Whooping Cough, Scarlet Fever, Puerperal Pyrexia and Pneumonia in this order were the next most frequent illnesses. Seventy-seven out of 106 cases of whooping cough were under the age of 5 years, whereas 54 out of 68 cases of scarlet fever were between the ages of 5 5 and 14 years. There seem to be two peak periods for whooping cough: December to January, and May to August. Scarlet fever has no settled peak period, and over the years every month produces a varying quota of cases. Indeed, it is now almost difficult to speak truly of an epidemic. From time to time scarlet fever presents a particular problem, especially when it occurs in the home of a food vendor—and several such cases were investigated—or in a hospital. In September a suspected case occurred in the Maternity Hospital. The case was removed to the Isolation Hospital, but this rash was found later to be an allergy due to sensitivity to chloral. However, certain precautionary measures were taken. The Hospital was closed as far as admitting any further In-patients for a week. Patients remained in hospital, but were discharged home at as early a date as possible. The Out-patient Clinics were allowed to continue. All personnel in the hospital had nose and throat swabs investigated. All Wards were washed with antiseptic and all linen was laundered. The incident showed how quickly measures, including the re-directing of admissions, could be carried out. All staff at this hospital have throat swabs examined monthly as a normal routine precaution, and in emergencies there is the closest co-operation between the Management and the Health Department. Pneumonia was associated with the influenza epidemic which occurred from December to March. There were no deaths due to influenza. There were 31 deaths due to other types of pneumonia. In 1952, and again this year, the majority of cases of poliomyelitis occurred in the latter part of the year from September to December rather than in the "polio" months of July and August. There was one death in a young woman who contracted a fulminating disease on holiday in Northern Italy, and died the day after admission to hospital. There were no known secondary cases. Seven out of 9 paralytic cases and 3 out of 4 non-paralytic cases were admitted to hospital. The high hospital admission rate is to be regarded as a praiseworthy measure of care on the part of our doctors in seeking confirmation of diagnosis and early treatment. All homes were visited. No information could be obtained of possible sources of infection except in one instance where a young man attended a party in a Co-operative Hall near the Neasdon Isolation Hospital at a time when there were many cases in this hospital. Before the disease appeared in Beckenham it had been present for some time in the North-West part of Greater London, and in Lewisham and then Bromley. It was not necessary to exclude adult contacts from work, but one firm had given an employee three weeks leave on full pay. Two cases of meningococcal infection were admitted to hospital; one a baby of 21 months, whose illness was believed to have been brought on by a fall the day before admission to hospital. The other illness occurred in a young woman following an attack of influenza and was diagnosed after admission to hospital. 6 The case of Typhoid Fever occurred in a Civil Servant returned from West Africa. His illness on the voyage was thought to be Malaria, but the diagnosis was made after his admission to hospital. On admission he was gravely ill with complications, but made an uneventful recovery, which was confirmed by the necessary blood tests for virulence. Another suspected case of typhoid fever in a person returned from Dacca, Pakistan, was not confirmed by the London Hospital for Tropical Diseases, to which he was admitted, and where he was found to have Malaria. During the year 188 faeces, urine and throat swabs were sent for examination. Nineteen faeces were sent for a special routine examination for Bact Coli type 026 to prevent carriers of infantile diarrhoea entering a Baby Home. Forty-eight faeces were sent in connection with the diagnosis of dysentery and 61 in connection with food poisoning. The urine examinations were in connection with a case of typhoid fever, and the throat swabs were taken in cases of scarlet fever and glandular fever. Organisms isolated were Bact Coli type 026 (one case), Salmonella Typhimurium (eight cases of food poisoning, including a case diagnosed clinically as dysentery), Salmonella Anatum (one case of food poisoning resistant to Aureomycin), Shigella Sonnei (three cases of dysentery), Pyocyanea (one case of dysentery), B. Proteus (one case of dysentery). All outbreaks of food poisoning were single cases, and in no case could any special food be incriminated. The human carrier problem in connection with Salmonella typhimurium was illustrated in one family in which a child of 6 years was first taken ill. Specimens from father, mother and two sisters were all negative. The father was taken ill 19 days later, after the child had recovered, and the same organism was isolated from the faeces. All other contacts were now negative. There were eleven fewer cases of tuberculosis, and Dr. Madigan's Report deals fully with the present position. The Mass Radiography figures show a decrease in the number of new cases over the past five years. Medical Applications for Rehousing. In November, 1952, this Authority adopted a revised points scheme on the classification of housing applicants. In the scheme the additional factors to be taken into account were Bedroom Deficiency, Shared Accommodation, Lack of Facilities, Lack of Natural Light, Size of Rooms, Broken Families, General Health, Period of Waiting List, Special Hardships, War Service, Residence and for War Widow. These were listed A to L, and for general health points would be awarded by the Medical Officer of Health. Infective pulmonary tubercular cases and others requiring urgent rehousing on medical grounds and diseases and physical disabilities 7 which, when considered in conjunction with housing conditions, should be taken into account in assessing hardship, were to be referred to the Medical Officer of Health for his consideration. In 1952 there were well over 2,000 families on the list, and with this revision and since a considerable number of medical applications have been considered. This year a record has been kept of these applications, which are now greatly reduced in number, and an analysis has been made of 59 new applications to the supplementary housing list. The maximum medical points (30 points) were recommended in 15 cases; and in three of these the circumstances were such that detailed reports were completed for the Sub-committee so that these cases, on their merits, could be considered out of their normal points turn. Two examples may be given. A brother and sister lived alone. The sister was over 60 years and had an artificial leg to the hip, which, because of pain, could not be used; the brother, a few years younger, and an invalid, helped his sister down twenty-five steps to the lavatory and kitchen. In another instance an old age pensioner over 80 years, and his wife over 60 years, lived alone and had twenty-six steps down a very awkward staircase to an outside lavatory. The husband, with a history of a stroke, was to be discharged from hospital after an operation on a broken hip; the wife had a history of a fractured knee-cap. There was a risk of further stumbling and injury. In the remaining applications the distribution of points was as follows: Twenty points were awarded in 9 cases; fifteen points in 20 cases; ten points in 12 cases; five points in 3 cases. Thus in 74 per cent of applications a half or more of the maximum medical points permitted were awarded. The ages of the applicants were made up as follows: 80—90 years, 2; 70—80 years, 6; 60—70 years, 9; 50—60 years, 4; 40—50 years, 9. The medical causes are given below:— NUMBER PERCENTAG Tuberculosis 6 9% Chest 10 16% Colds 3 4% Rheumatism or Arthritis 9 14% Anxiety state or nervous illness 15* 24% Cardiac 5† 8% Other diseases 14‡ 21% *Includes one case of Alopecia due to worry and two cases of Epilepsy, †Includes two cases of Coronary Thrombosis. ‡Includes two cases of Varicose Veins; one case of Diabetes; one case of Menieres Disease; four cases of Gynaecological disease or operation. 8 Health Services. Of these services the supervision of some is the direct delegated responsibility of the Borough Council, but in all, in some way or other, the Council is indirectly concerned. They are listed in the middle of this report. I would like to comment on a few. Private Nursing Homes. These provide a total of 115 beds. They are adapted private houses of varying design and of different ages, and, like the occupants, in the main elderly. They provide problems in repair and maintenance, of economical running which requires constant supervision of bed spacing and of the proper proportion of nursing staff to patients. Local bye-laws provide basic sanitary requirements and the permitted number of patients, but these are more helpful in the original registration of the home. The question of overcrowding or poor services must be decided on medical grounds for individual homes, as and when they occur. The problem of the hospitals is lack of nursing and domestic staffs, but this is greater in the homes because of the types of patient and the difficult conditions under which the staff work. Care of Elderly Persons. The report of the local branch of the Women's Voluntary Service refers to four sections of their work for the elderly, in the Darby and Joan Clubs and associated activities, in Welfare and in the Luncheon Club. The fourth section, the Meals on Wheels, exists for the benefit of invalids and elderly persons who cannot do their own shopping or cooking, but have their own homes. If assistance, not provided by relatives or friends, is needed in washing, dressing and walking, accommodation in Old Persons Homes has to be provided through the County Authority. If the elderly person becomes bedfast and in need of nursing care, admission to hospital or private nursing home is usually needed. There are many bedfast old persons for whom Home Nursing, even combined with a Home Help, is inadequate over a period of months or years. Another valuable local service for the elderly is subsidised by the local branch of the British Red Cross. A Foot Clinic is held weekly to which any person over 60 years can attend for treatment. The fee varies from nil to 3/- a treatment, and where the fee or part is remitted, the difference is made up by the British Red Cross. The Cadets of the British Red Cross also help certain elderly persons by shopping, reading at home to them, taking them out in bathchairs, and at Christmas collecting for presents for them. Senior members of the Red Cross act as escorts to blind and elderly persons who have to travel by bus or train to Out-patient Departments of London Hospitals. In view of the high proportion of hospital beds occupied by the 9 elderly, the local help given to hospitals jointly by the W.V.S. and Red Cross in connection with the Trolley Shop and Canteen must be counted as a local service to the elderly. The Friends of Beckenham Hospitals also help with extra amenities. Members of the Inner-Wheel visit old people in their homes; holidays for old age pensioners are arranged by the Round Table; Rotary, the Parochial Charities Trust, and other organisations help locally. To all these voluntary services and the members thereof no praise can be too high for their valuable help in rounding off the basic national services and high-lighting some of the deficiencies which still exist. Vaccination and Immunisation. 1,398 diphtheria immunisations, 860 smallpox vaccinations and 60 B.C.G. vaccinations against tuberculosis were carried out. In each there is a slight increase over last year, when these results were described as excellent. Not all the immunisations recorded were carried out in the Clinics, for a large number were part of the combined immunisation against whooping cough, diphtheria and Tetanus which are normally carried out by most medical practitioners in this area. Environmental Services. Noise is becoming a major nuisance of the times, accentuated by the improved hearing of the Age. It is also as difficult to measure and define as is health. To be dealt with by statutory powers noise must be proved to be prejudicial to health or a nuisance ; also that the best practical means of prevention had not been adopted. If such a nuisance occurs, it is speedily investigated and dealt with in a commonsense and practical manner by the Inspectors of the Health Department. Food poisoning is intimately concerned with food hygiene, and a graph shows the incidence of notified cases in Beckenham. The Medical Research Council have suggested that the different bacterial cases of food poisoning require different approaches to the problem. The control of salmonella infection is a most difficult problem, and an intensified search for contamination of substances used in food manufacture, such as egg products, offal, sausage meat, is the most important step. Welchii infection could best be controlled by not cooking meat or gravy in bulk the day before it is eaten, and perhaps by cutting out the reheating of meat dishes. At the end of the year Food Hygiene Regulations were laid before Parliament, and in the coming year it is hoped to have a workable set of Regulations under the Food and Drugs Act, 1955. In conclusion, I wish to thank Dr. Elliott and his staff for their co-operation during the year. My own staff have worked with enthusiasm, initiative and zeal, and the Committee have given me the greatest possible support and encouragement. L. R. L. EDWARDS, Medical Officer of Health. 10 SUMMARY OF VITAL STATISTICS, 1955 Area of District in acres 5,935 Civilian Population as estimated by the Registrar-General at 30th June, 1955 75,340 Civilian population per acre 12.7 Rateable Value at 1st October, 1955 £921,020 Births Registered (Including Stillbirths): Male Female Legitimate 465 382 Illegitimate 7 9 Total 863 Birth Rate (including Stillbirths) per 1,000 of Civilian Population (Corrected) (11.45 X 1.07) 12.25 (Crude) 11.45 Male Female Deaths Registered 410 426 Total 836 Death Rate per 1,000 population (Corrected) (11.08 X 0.88) 9.76 (Crude) 11.1 Infant Mortality Rate per 1,000 live births 17.38 Maternal Mortality Rate per 1,000 births 0.00 Deaths of Infants under 1 year of age: Male Female Legitimate10 5 Illegitimate — — Total 15 Still Births: Rate per 1,000 population 0.12 Rate per 1,000 live births 14.28 Male Female Legitimate 4 5 Illegitimate — — Total 9 Death Rate per 1,000 of Civilian Population from Cancer (152 deaths) 2.02 Death Rate per 1,000 of Civilian Population from Pulmonary Tuberculosis (6 deaths) 0.08 Death Rate per 1,000 of Civilian Population from Non- Pulmonary Tuberculosis (nil) 0.00 Death Rate per 1,000 of Civilian Population from Accidents (13 deaths) 0.17 Natural Increase: The Births registered exceeded the deaths by 18. 11 TOTAL DEATHS, 1955 (Registrar-General's Official Returns). All causes—836; Male, 410; Female, 426. causes of death males females 1. Tuberculosis, respiratory 6 2. Tuberculosis, other — — 3. Syphilitic disease 1 — 4. Diphtheria — — 5. Whooping Cough — — 6. Meningococcal infections — — 7. Acute poliomyelitis — 1 8. Measles — — 9. Other infective and parasitic diseases 1 1 10. Malignant neoplasm, stomach 10 8 11. Malignant neoplasm, lung, bronchus 31 3 12. Malignant neoplasm, breast — 12 13. Malignant neoplasm, uterus — 6 14. Other malignant and lymphatic neoplasms 37 45 15. Leukaemia, aleukaemia 1 2 16. Diabetes 2 6 17. Vascular lesions of nervous system 52 71 18. Coronary disease, angina 96 62 19. Hypertension with heart disease 11 8 20. Other heart disease 41 93 21. Other circulatory disease 18 27 22. Influenza — — 23. Pneumonia 17 14 24. Bronchitis 25 9 25. Other diseases of respiratory system 7 5 26. Ulcer of stomach and duodenum 3 2 27. Gastritis, enteritis and diarrhœa 2 — 28. Nephritis and nephrosis 3 3 29. Hyperplasia of prostate 8 — 30. Pregnancy, childbirth, abortion — — 31. Congenital malformations 3 1 32. Other defined and ill-defined diseases 23 39 33. Motor vehicle accidents 4 3 34. All other accidents 4 2 35. Suicide 4 3 36. Homicide and operations of war — — Totals 410 426 12 CANCER DEATHS 1951 1952 1953 1954 1955 Cancer of Lung 16 28 36 42 34 Males 130 Females 26 Total 156 Cancer of Breast 12 24 17 22 12 87 Cancer of Uterus 7 5 3 4 6 25 Cancer of Stomach 21 17 17 16 18 Males 50 Females 39 Total 89 Other Malignant Neoplasms 73 97 83 100 82 Males 209 Females 226 Total 435 Deaths 129 171 156 184 152 For comparison, deaths from Respiratory Tuberculosis are shown:— 1951 1952 1953 1954 1955 10 10 6 8 6 Males 35 Females 14 Total 49 13 INFANTILE MORTALITY, 1955 The number of deaths of infants under the age of twelve months was 15 as compared with 21 in 1954. The Registrar-General returns 22 infants deaths and the Infant Mortality Rate for the year was 17.38 per 1,000 live births. The following Table shows the cause of death in 15 cases for which full records exist. Table of Infantile Mortality. Age in Weeks. Total under one mth. Age in Months. Total under one year. under 1 1-2 2-3 3-4 1-3 4-6 7-9 10-12 A. Congenital Defects — — 1 1 — — 1 — 2 B. Ante-natal or Intranatal Conditions 6 6 6 C. Infections — — 1 — 1 3 1 1 1 7 D. Accidental Totals 6 — 1 1 8 3 1 2 1 15 Deaths—Males, 10; Females, 5. B—Prematurity accounted for 5 deaths. Cerebral haemorrhage for 1 death. 14 15 VITAL STATISTICS FOR YEARS 1947 to 1955 THE COMPARATIVE RATES GIVEN REVEAL SOME INTERESTING TENDENCIES Year Population as estimated at mid-June by RegistrarGeneral Live Births Registered Still Births Deaths of Infants under one year Legitimate Illegitimate Total Rate per 1,000 population Legitimate Illegitimate Total Legitimate Illegitimate Total Rate per 1,000 live Births 1947 74,030 1,278 36 1,314 17.749 36 3 39 33 4 37 28.15 1948 75,050 1,051 22 1,073 14.297 22 2 24 12 3 15 13.98 1949 75,630 1,046 30 1,076 14.227 23 1 24 29 - 29 26.95 1950 75,850 895 24 919 12.116 18 - 18 18 - 18 19.58 1951 74,880 937 24 961 12.833 15 1 16 26 1 27 28.09 1952 75,160 906 16 922 12.267 15 - 15 16 1 17 18.43 1953 75,120 856 22 878 12.505 12 1 13 10 1 11 12.53 1954 75,280 872 19 891 11.835 10 1 11 20 1 21 23.57 1955 75,340 838 16 854 11.335 9 — 9 15 — 15 17.38 Year Deaths of Civilians from all causes (including enemy action) Deaths of Mothers in Childbirth Deaths from Pulmonary Tuberculosis Deaths from all forms of Cancer Number Rate per 1,000 population Number Number Rate per 1,000 population Number Rate per 1,000 population 1947 736 9.975 3 19 0.256 136 1.775 1948 695 9.260 1 26 0.346 128 1.706 1949 798 10.551 1 22 0.290 130 1.718 1950 783 10.323 — 18 0.237 131 1 727 1951 832 11.111 1 10 0.133 129 1.709 1952 890 11.841 1 10 0.133 171 2.275 1953 819 9.593 — 6 0.080 156 2.076 1954 828 10.998 — 8 0.106 184 2.444 1955 836 11.096 — 6 0.080 152 2.017 16 17 18 INFECTIOUS DISEASE (1) DISEASE 0—4 years 5—14 years 15 years and over Age Unknown TOTAL ADMITTED TO HOSPITAL M. F. M. F. M. F. M. F. M. F. M. F. Cerebral-Spinal Meningitis 1 - - - - 1 - - 1 1 1 1 Dysentery (Bacillary) - 1 1 2 1 1 - - 2 4 - - Erysipelas — — - - 2 4 - - 2 4 1 - Food Poisoning 1 1 4 1 1 1 - - 6 3 - - Measles 232 212 282 235 4 7 2 2 520 456 1 - Pneumonia 3 - 3 2 11 13 - 1 17 16 3 1 Poliomyelitis: Paralytic — 1 2 2 2 2 - - 4 5 4 3 Non-Paralytic 2 — 1 - 1 - - - 4 - 3 - Puerperal Pyrexia — — — - — 37 - - - 37 - 37 Scarlet Fever 7 5 27 27 - 2 - - 34 34 10 9 Typhoid — — - - 1 - - - 1 - 1 - Whooping Cough 35 42 14 15 - - — - 49 57 - 1 19 INFECTIOUS DISEASE (2). The following Table gives the number of cases notified during the year:— disease jan. feb. mar. apr. may june july aug. sept. oct. nov. dec. total Cerebro-Spinal Meningitis — — 1 — 1 — — — — — — — 2 Dysentery (Bacillary) 1 — — — — 4 1 — — — — — 6 Erysipelas — 1 — — — 1 1 2 1 — — — 6 Food Poisoning — — — — — 4 5 — — — — — 9 Measles 100 321 315 135 54 34 9 8 — — — — 976 Pneumonia 9 10 8 1 1 1 — — — 2 — 1 33 Poliomyelitis: Paralytic — — — — — 2 — — 1 2 3 1 9 Non-Paralytic — — — 1 — — — 1 — — 2 — 4 Puerperal Pyrexia 3 3 4 3 9 6 1 — — 3 1 4 37 Scarlet Fever 2 2 8 1 9 15 12 2 1 7 2 7 68 Typhoid 1 — — — — — — — — — — — 1 Whooping Cough 18 4 9 5 11 13 18 12 5 5 5 1 106 Totals 134 341 345 146 85 80 47 25 8 19 13 14 1257 20 INFECTIOUS DISEASE (3) disease wards L. Pk. and K.H. C.C. C.H. M.H. E.P. Shortlands W.W. (North) W.W. (South) Cerebral-Spinal Meningitis — — — — — 2 — — Dysentery (Bacillary) 3 1 — — — 1 — 1 Erysipelas 1 — 1 1 1 — — 2 Food Poisoning — 4 — — 3 2 — — Measles 140 117 158 195 109 119 43 95 Pneumonia 2 — 5 16 4 3 I 2 Poliomyelitis: Paralytic — — 3 2 — 1 3 — Non-paralytic — 1 2 — — — 1 — Puerperal Pyrexia — — — — 37 — — — Scarlet Fever 9 7 3 13 10 7 8 11 Typhoid — — 1 — — — — — Whooping Cough 10 20 24 18 9 2 10 13 Totals 165 150 197 245 173 137 66 124 *L. Pk. amd K.H.—Lawrie Park and Kent House. M.H.—Manor House. C.C.—Copers Cope. C.H.—Clock House. E.P.—Eden Park. W.W. (North)—West Wickham North. W.W. (South)—West Wickham South. 21 TUBERCULOSIS—Table of Notifications and Deaths, 1955, from Local Records. Se.x Total Ages Wards* 0 to 5 6 to 10 11 to 15 16 to 20 21 to 25 26 to 35 36 to 45 46 to 55 56 to 65 66 and over Age unknown L.Pk. and K.H. M.H. C.C. C.H. E.P. Shortlands W.W. (Nth.) W.W. (Sth.) M. F. notifications New Cases only Pulmonary 27 23 50 — 1 1 6 4 7 9 8 8 5 1 13 5 9 4 1 4 8 6 Non-Pulmonary 2 1 3 — — 1 1 — — — 1 — — — 1 — — 1 — — 1 — Totals 29 24 53 — 1 2 7 4 7 9 9 8 5 1 14 5 9 5 1 4 9 6 Deaths Pulmonary 7 — 7 — — — — — — — 1 2 4 — — 1 — 4 I — 1 — Non-Pulmonary Totals 7 — 7 — — — — — — — 1 2 4 — — 1 — 4 1 — 1 — *L.Pk. and K..H.—Lawrie Park and Kent House. M.H.—Manor House. C.C.—Copers Cope. C.H.—Clock House. E.P.—Eden Park. W.W. (North)—West Wickham North. W.W. (South)—West Wickham (South). 22 MASS RADIOGRAPHY (Beckenham including West Wickham), 1951-55 1951 1952 West Wickham only 1954 1955 total Total—Radiographed 5,887 5,957 1,537* 6,643* 20,024 Total—All Abnormalities 123 177 18 115 333 Probable new cases of Pulmonary T.B. 38 46 3 (0.48%) 19 106 Previously known cases of Pulmonary T.B. 11 12 2 6 31 Heart and Circulatory Disease 12 8 1 10 31 Other Chest Abnormalities 62 111 12 80 265 Length of Survey 15 days 34 days 6 days 27 days 82 days "Over 40% were X-rayed for the first time. By applying this figure to 1951 and 1952, incidence of new cases of Pulmonary T.B. estimated as 0.71% in 1955 compared with 1.6% in 1951 and 1.5% in 1952. WORK OF THE CHEST CLINICS I again express my thanks to Dr. Madigan for the following report on the work of the Chest Clinics and the subsequent Table. "As will be seen from the Table, the numbers of newly diagnosed cases of tuberculosis are practically the same as for 1954. The total number of cases referred for investigation, however, has shown a progressive drop over recent years. Whether greater use of the Mass X-ray Service, or direct reference to Radiological Departments of local hospitals, has any bearing on this 1 do not know. I trust, however, that the knowledge that tuberculosis can be successfully treated by modern methods is not inducing a feeling of complacency towards the disease into the minds of the general public. Early, and full, investigation into abnormal symptoms is still as essential today as in the past, if we are to consolidate the advance of recent years in combating this disease. "Fewer new contacts came for examination than in the previous year, although the average over the past few years has been well maintained. It is worth noting that none of these new contacts was found to be positive. B.C.G. vaccination is now offered to Mantoux negative contacts up to adult age, and 60 such contacts were given B.C.G. during the year. "The number of admissions to Hospitals or Sanatoria has not varied much from last year, and it is still possible to secure fairly early admission of all types of cases." New Cases attending the Tuberculosis Dispensaries for the first time during 1955. Adults Children under 15 years Male Female Male Female Pulmonary 29 22 — — Non-Pulmonary — — — — Negative 49 39 9 5 Negative Positive Contacts Examined 158 — Number of patients admitted to Sanatoria during the year: 53. These figures relate to patients resident in Beckenham Borough only. 23 BECKENHAM TUBERCULOSIS CARE COMMITTEE I am grateful to Mr. M. E. Forster, Hon. Secretary of the Beckenham District Tuberculosis Care Committee, for again submitting a report on the Committee's valuable work during the year under review: "The Beckenham District Tuberculosis Care Committee, which is associated with the Kent Council of Social Services, continued its voluntary welfare work amongst tuberculosis patients and their families in the Borough. The Committee assist patients and families who are recommended by the local Chest Clinic or Health Visitors. This may take the form of providing extra nourishment, purchasing clothes and shoes, or furnishings, assisting with debts that have accumulated, sending families away for holidays, and paying fares for near relations to visit hospitals and sanatoria. The two Liason Officers spent a considerable amount of time visiting families in their homes and arranging this help. Approximately one-third of the help given was to families in the West Wickham area. "At Christmas-time 60 patients received gifts to enable them to purchase something extra. "During the year the Committee spent over £450, and to offset this an energetic drive was made to bring in funds through the sale of Christmas Seals, which was met with generous response. "Mrs. S. E. Porter resigned as Chairman in September due to her husband's retirement, and her duties were taken over by Mr. S. W. Collett, who had been Hon. Secretary since the Committee was formed in 1938 until early 1955." WOMAN'S VOLUNTARY SERVICE The following report on the work of the W.V.S. work in the Borough has been submitted by Mrs. J.M. Fisher,the Centre Organiser, to whom 1 express my thanks. Darby and Joan Clubs. Three Darby and Joan Clubs in Beckenham, and two Over 60's Clubs in West Wickham, are still running in the Borough. Two of the Clubs are held on Tuesday and one on Thursday from 1.45 p.m. to 4.15 p.m. Membership of each Club averages 100/120, and all the members are over 60 years of age. The membership fee is 1d. and a charge of 3d. is made for a varied tea per person. Whist Drives, Darts matches and Raffles are held each week, and at least two of the Clubs have talented Choirs which entertain not only their own members, but other organisations. A free library is available to members, and there are also plenty of magazines for reading. Members are going to Eastbourne next month for a week's holiday under the scheme arranged for old age pensioners. Spring and Autumn outings by coach are arranged for the Club 24 members, and in the winter there are visits to Pantomimes and Ice Shows. A Savings Group is run for members who wish to save weekly towards holidays, outings, etc. The Clubs are subsidised by voluntary subscriptions. The two Over 60's Clubs are run in West Wickham with an average membership of 130/150. Meals on Wheels. Meals are still served twice a week, Tuesdays and Fridays. The service is run principally for the benefit of invalids, and elderly people who cannot shop or cook for themselves. Appeals for these meals usually come from Hospital Almoners, Doctors, and through the Darby and Joan Clubs. The meals are provided by a local Canteen, and an allowance towards the cost of Transport is made through the local and County Authorities. Cost of the meals is subsidised by voluntary funds, and those in need are only required to pay a very small sum for the service. West Wickham Luncheon Club. Meals for this Luncheon Club are cooked by the W.V.S. and only a nominal charge is made. An average of 25 meals are served weekly, in addition to an average of 16 meals on wheels twice a week. Old People's Welfare. Visits are made to elderly people who live alone, and assistance is given with regard to clothing, which is supplied free on the authority of the National Assistance Board, District Nurses, etc. Hospital Work Work in connection with Beckenham Hospital has been much appreciated, and consists of help with the library, flowers and magazines. Other work is done at Swanley Hospital and at the Heart Hospital, West Wickham. Maternity Home. Many baby garments have been knitted, and we now have a Guild of Service which will supply help personally to the Matron. This Guild consists of W.V.S. and non-W.V.S. from Beckenham and Penge. Baby Clinics. Helpers are supplied at three of the baby clinics in the Borough, and assist in the selling of Welfare Foods, weighing and clerical work. S.S.A.F.A. The local branch of S.S.A.F.A. is still run by W.V.S. from our own Centre, and since last year around £600 has passed through its hands. Apart from financial help, clothing has been given and advice on many matters. Clothing Depot. The stock in our Clothing Depot has been somewhat depleted recently, but we are able to help many cases who come to us with authority from such organisations as the National Assistance Board. 25 The Children's Clothing Exchange is still being run every Wednesday, and the Centre dispenses National Dried Milk, in addition to Orange Juice, Cod Liver Oil and Vitamin Tablets. In addition to the aforementioned activities, the W.V.S. has a close liaison with the Tuberculosis After Care Committee, Area Pension Officer, British Legion, the Disabled Persons Committee and Children's Homes. BECKENHAM OLD PEOPLE'S WELFARE COMMITTEE This voluntary Committee was formed in 1942 to help lonely elderly folk who had lost their homes through bombing. The Committee meets three times a year and co-ordinates the activities in respect of old people's welfare of the various organisations whose representatives attend. The organisations are listed below:— C.R.S. (Companionship of Remembrance and Service). W.V.S. and Over 60's Club. National Assistance Board. Anglican Churches. British Red Cross. Women's Co-operative Guild. Inner Wheel. W.V.S. and Darby and Joan Clubs. Beckenham Women's Citizens' Association. Women's Free Church Council. Rotary and Veteran's Clubs. Eden Park Co-operative Guild. Home Help Service (K.C.C.). NATIONAL ASSISTANCE ACT, 1948—SECTION 47 Under Section 47 of the above Act as amended by the National Assistance (Amendment) Act, 1951, persons suffering from grave chronic disease, or who are aged, infirm or physically handicapped and who are living in insanitary conditions and unable to devote to themselves, and not receiving from other persons, proper care and attention, may be compulsorily removed. Several possible cases were visited and investigated during the year. VACCINATION AND IMMUNISATION (a) The number of Sessions held during the year was 456 (b) Attendances during the same period 19,700 DIPHTHERIA IMMUNISATION. (a) The number of Sessions held during the year (in conjunction with Child Welfare Clinics) 356 (b) Attendances during the same period 619 SMALLPOX VACCINATION, (a) The number of Sessions held during the year (in conjunction with Child Welfare Clinics) was (b) The number of vaccinations given was 418 26 Immunisation against Diphtheria and Vaccination against Smallpox, 1955. (A) DIPHTHERIA IMMUNISATION. Year of Birth. 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 Total Primary Inoculations. 90 518 60 9 12 15 16 2 1 1 1 1 — — — 726 Re-inforcing Inoculations. — — — 1 27 364 110 48 36 42 17 16 6 4 1 672 (B) VACCINATION. Year of Birth. 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 Before 1941 Total. Primary Vaccination. 395 244 7 8 5 1 2 2 — — 3 3 3 2 — 50 725 ReVaccination. 2 1 — 2 — 3 2 — 2 2 — 8 2 2 1 108 135 MORBIDITY RETURNS, 1955 certificates of incapacity first intermediate final total January (ended 25.1.55) 1613 4791 964 7368 February (ended 22.2.55) 1575 4876 1292 7743 March (ended 29.3.55) 1724 5825 1445 8994 April (ended 26.4.55) 959 4403 919 6281 May (ended 31.5.55) 881 5198 793 6872 June (ended 28.6.55) 704 4108 667 5479 July (ended 26.7.55) 629 3867 592 5088 August (ended 30.8.55) 676 4522 568 5766 September (ended 27.9.55) 601 3708 485 4794 October (ended 25.10.55) 878 3808 623 5309 November (ended 29.11.55) 1243 4963 1009 7215 December ( to 3rd January, 1956) 1079 4304 873 6256 27 HEALTH SERVICES 1. Hospitals and Clinics. Beckenham Hospital—Croydon Road, Beckenham. Beckenham Maternity Hospital—Stone Park Avenue, Beckenham. Widmore Road and Mason's Hill Maternity Units, Bromley, Kent. Bromley Hospital—Cromwell Avenue, Bromley, Kent. Children's Heart Hospital—West Wickham. Children's Hospital—Sydenham. Farnborough Hospital—Farnborough. Lennard Isolation Hospital—Bromley Common. The Babies' Hospital—Sydenham Hill. Bromley Chest Clinic—Tiger Lane, Masons Hill, Bromley. Penge Chest Clinic—1, Westbury Road, Penge. 2. Other Services (Kent County Council). Home Helps. Beckenham District Office, 12, Beckenham Road, Beckenham. Home Nurses. Beckenham District Office, 12, Beckenham Road, Beckenham. Midwives. West Wickham : 4, Grosvenor Road. 105a, Station Road. Beckenham : 12, Beckenham Road, Beckenham. Ambulances. Through Hospital or Beckenham District Office. Old People's Homes. Durham House, Durham Avenue, Short- lands. Thornton House, 79, Bromley Road, Beckenham. The Chestnuts, Gwydor Road, Beckenham. Rutland Lodge, Mays Hill Road, Shortlands. Mental Welfare. District Offices, Beckenham Road, Beckenham. General Welfare. District Offices, Beckenham Road, Beckenham. Clinics for Maternity and Child Welfare. 28 3. Private and Voluntary Services. Private Nursing Homes. (1) 54, The Avenue, Beckenham. (2) " Parklands," 51, Crystal Palace Park Road. (3) " Petersfield Lodge," 69, Crystal Palace Park Road. (4) " Inglewood," 25, Durham Avenue, Bromley. (5) 131, Albemarle Road, Beckenham. (6) 14, Bromley Grove, Shortlands. Registration and supervision is delegated to the Borough Council. Children's Homes. (1) Maude Nathan Home, 72, Crystal Palace Park Road, S.E.26. (2) Salvation Army Children's Home, 42, Crystal Palace Park Road, S.E.26. (3) Dr. Barnardo's Home, 16, Park Road, Beckenham. (4) The Aberdare Memorial Home for Boys, West Wickham. (5) St. Hilda's Home, Crescent Road, Beckenham. (6) The Home of Compassion, Bromley Road, Beckenham. Medical Loan Depot of B.R.C.S. 45, Beckenham Road, Beckenham. Women's Voluntary Services. 12, Bromley Road, Beckenham. 103, High Street, West Wickham, Kent. Private Day Nursery. Sussex Road, West Wickham. 9.15—12 a.m., Mon.-Fri. inc. 29 LOCAL CLINICS FOR MATERNITY AND CHILD WELFARE Service Days and Times Premises in Use Ante-Natal 2nd and 4th Fridays in each month, 10—12 noon (by appointment) Clinic Block, Town Hall, Beckenham Other Fridays in each month, 2—4 p.m. (by appointment) Monday to Friday inclusive Clinic Block, Hawes Lane, W. Wickham Maternity Hospital, Stone Park Avenue Child Welfare Monday, 2—4 p.m. Clinic Block, Hawes Lane, W. Wickham Tuesdays, 2—4 p.m. Baths Annexe, Beckenham Road. Assembly Hall, West Wickham Wednesday, 2—4 p.m. Church Hall, Langley Road, Elmers End. Church Hall, Valley Road, Shortlands Thursday, 10—12 noon Church Hall, Lennard Road, Penge 2—4 p.m. Thursday, 2—4 p.m. Clinic Block, Town Hall, Beckenham Clinic Block, Hawes Lane, W. Wickham Fridays, 2—4 p.m. Church Hall. Langley Road, Elmers End Post-Natal Friday, 10—12 noon (by appointment) Maternity Hospital, Stone Park Avenue Vaccination (by appointment only) and Diphtheria Immunisation are carried out during certain Infant Welfare Sessions at the above Clinics. Service Days and Times Premises in Use Dental (Infant Welfare Cases) By appointment Clinic Block, Town Hall By appointment Clinic Block, Hawes Lane, W. Wickham Speech Mondays, Tuesdays and Thursdays all day Town Hall Clinic Wednesday mornings (by appointment only) Orthopaedic Wednesday mornings (twice per month) (by appointment) Clinic Block, Town Hall, Beckenham Treatment Surgeon in attendance The Physiotherapist attends Mondays—All day Wednesdays—All day Thursdays—Afternoon Fridays—All day Tuesdays—Mornings by appointment, as follows Clinic Block, Town Hall, Beckenham Clinic Block, Hawes Lane, West Wickham Mothercraft Classes and Relaxation Exercises 1st and 3rd Fridays in each month, 10—12 noon Clinic Block, Town Hall, Beckenham 2nd and 4th Fridays in each month, 2—4 p.m. Clinic Block, Hawes Lane, W. Wickham 30 REPORT ON THE SANITARY ADMINISTRATION of the DISTRICT FOR THE YEAR 1955 By G. A. Webber, Chief Sanitary Inspector, Borough of Beckenham. The Annual Report for 1954 drew attention to one vacancy on the establishment of Sanitary Inspectors which had existed throughout that year. The position worsened in June, 1955, when the resignation of Mr. H. R. Dawkins increased the number of vacancies to two. However, after repeated advertisement, both were filled in September, 1955, when Mr. J. A. Keen and Mr. T. P. Jarrett joined the staff. A wide divergency of problems continued to be brought to our notice during the year, but we were again mainly concerned with the investigation of complaints regarding house property, the maintenance in good repair of old property, the inspection of food and food shops, and factories and general shops, and rodent control. Other matters of equal importance, but of less regular occurrence, included noise and smoke nuisances, the pollution of streams, school sanitation, domestic servants' registries, water supply, moveable dwellings, insect pests, legal proceedings, and, in certain cases, the burial of the dead. 1,236 complaints relating to one or other of these matters were received and investigated during the year, but a good deal of inspection of properties is made, and many nuisances discovered, without complaint having been lodged. 8,111 visits and re-visits were made by the Sanitary Inspectors, which number includes 1,281 relating to food shops. The remedy of nuisance is mainly secured by informal action, but it was found necessary to serve 22 Statutory Notices before the abatement of nuisances could be secured. In all, 1,883 nuisances were remedied during the year. Housing Acts. The repair and maintenance of older residential properties in the borough, in accordance with procedure laid down by the Housing Acts, continued throughout the year. 40 properties were dealt with, and again I am able to report that the owners of these properties offered the greatest co-operation in dealing with the items of disrepair brought to their notice. In 23 cases where owners exercised their right to increase rental the occupiers applied for Certificates of Disrepair. Fifteen such Certificates were granted, of which 12 were revoked after completion of the necessary works. Statistical information, relating to the work of the Inspectors, is appended:— 31 Number of complaints received and investigated 1,236 Number of initial visits 4,073 Number of re-visits 4,038 Number of Intimation Notices served 155 Number of Statutory Notices served 22 Nuisances Remedied. Structural defects—external 444 Structural defects—internal 892 Verminous conditions 2 Insanitary conditions, other than vermin 30 Choked drains 221 Other drainage defects 167 Defective sanitary appliances 91 Insufficient or unsuitable water supply 3 Absence of dustbins 30 Offensive accumulations 2 Smoke nuisances 1 1,883 Dustbin Accommodation. It was necessary to report 9 cases of insufficient or unsuitable dustbin accommodation in properties in the Borough. The Council has to determine whether the Statutory Notice calling for proper provision shall be served upon the owner or occupier of the property. In order to assist in a fair determination, information is obtained regarding the rental of the property, the age and treatment of the offending bin, and any relevant comments which, on invitation, the owner and tenant submit. The Public Health Committee decided, in six cases, that the owner should be held responsible, and in the remaining three cases the Notices were served, at the Committee's direction, upon the occupiers. New legislation provided by the Local Government (Miscellaneous Provisions) Act, 1953, helped in small measure to clarify the legal position affecting dustbin provision. A local authority has still to decide, on the facts of the case, whether the Statutory Notice shall be served on the owner or occupier of a property, but whereas previously the Court could invalidate a decision of a local authority, the Bench may now make such order as it thinks fit with respect to compliance with the Notice either by the Owner or the Occupier, and any person appealing against the Notice of a local authority must serve a copy of his appeal on the other party concerned. Actually, during 1955 there were no appeals against the decisions arrived at by this Council. 32 Housing—Inspection of Dwelling Houses during the Year. Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 1,154 Number of inspections made for the purpose 3,841 Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 86 Number of inspections made for the purpose 667 Number of dwelling-houses (exclusive of those referred to under the following sub-head) found not to be in all respects reasonably fit for human habitation 155 Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 0 Number of dwelling-houses in respect of which informal notices were served 155 Number of dwelling-houses in which defects were remedied after service of informal notices 133 Number of dwelling-houses in respect of which formal notices were served requiring defects to be remedied 22 Number of dwelling-houses in which defects were remedied after service of formal notices: (a) by owners 22 (b) by Local Authority in default of owners 0 Unsound Food. There continues to exist the closest co-operation between the Vendors of food and the Council's Sanitary Inspectors. It was not necessary, during the year, formally to seize any unsound food offered and exposed for sale. As a result of our visits and inspection of suspect packs of foods, approximately 5 tons of various foodstuffs were condemned and surrendered by the Vendors for destruction under our supervision. Most of this condemned food was, in fact, found to be due to faulty processing in manufacture. 33 Details are appended of the formal and informal samples sub mitted to the Public Analyst during the year 1955:— article formal informal Soup-mix — 1 Strawberry Jam — 2 Apricot Jam — 3 Table Jelly — 3 Butter Crunch — 1 White Pepper — 2 Curry Powder — 2 Pie Filling — 1 Rice — 5 Custard Powder — 2 Blancmange Powder — 4 Coffee — 4 Cake Mix — 1 Sponge Mix — 1 Sterilised Cream — 1 Honeycomb Mould — 1 Cheese Spread with Ham — 1 Rum Flavour — 1 Essence of Rennett — 1 Tapioca Dessert — 1 Caraway Seeds — 2 Honey — 1 Plum Jam — 2 Stoned Raisins — 1 Cheese Spread — 8 Sago — 1 Vinegar (Malt) 1 1 Pasteurised Milk 23 — T.T. Milk 3 — T.T. Pasteurised Milk 2 — Milk — 3 Ice Cream — 17 Ice Cream Powder — 1 Marzipan — 2 Instant Pudding — 1 Chicken Soup — 1 Baking Powder — 1 Almond Flavouring — 1 Custard Flavour — 1 Frig-ice — 1 Ground Nutmeg — 2 Whipping Compound — 1 Processed Gruyere Cheese — 3 Meringue Powder — 4 Ham Spread — 1 Meat Paste — 2 Salmon Spread — 1 Norwegian Crab Paste — 1 Minced Turkey — 1 Dressed Crab — 3 Anchovy Paste — 1 Lemonade Crystals — 1 Cinnamon — 1 Hot Milk 3 — Rolls and Butter 3 — White Cake-mix — 1 Golden Pudding Mixture — 1 34 article formal informal Self-raising Flour — 1 Ground Ginger — 1 Flavouring Essence — 1 Beef Suet — 1 Chocolate Dessert Powder — 1 Sponge Flour Mixture — 1 Lemon Curd — 2 Dessert Powder — 2 Veal Paste — 1 Pork Sausages — 1 Pancake and Yorkshire Pudding Mixture — 3 Gingerbread Mixture — 1 Sweetened Cake Flour — 1 Iced Fancies — 1 Trifle Pack — 1 Preserved Ginger — 1 Real Minced Pork — 1 Cayenne Pepper — 1 Ground Paprika — 1 Minced Chicken — 1 Orangeade Powder — 1 Marmalade — 1 Lemon Flavouring Essence — 1 Powdered Soup (Tomato) — 1 Processed Gorgonzola Cheese — 1 Real Lemon Juice — 1 Orange Squash — 4 Milk Chocolate Caramels — 1 Mixed Fruit Jam — 1 Coffee Spread — 1 Complete Cake-mix — 2 Essence of Coffee and Chicory — 1 Cut Potato (Stained) — 1 Milk Bottle containing Foreign Matter 3 Full Cream Milk Chocolate — 2 Milk Chocolate Cigarettes — 1 Stuffed Pork and Meat Rolls — 1 Horseradish Sauce — 1 Christmas Pudding — 3 Gelatine — 1 Cream of Tartar — 1 Glucose Tablets — 1 Creamed Rice — 1 Meat Pudding — 1 Marmalade (Diabetic) — 1 Danish Cream — 1 Cheese and Tomato Spread — 1 Aspirin — 2 Chlorodyne — 1 Olive Oil — 1 Camphorated Oil — 1 Syrup of Figs — 1 Tincture of Iodine — 1 Liquorice and Menthol Pellets — 1 Lemskin Jelly — 1 Nippets " Throat Pastilles — 1 Ground Almonds — 3 35 article formal informal Mixed Cut Peel — 2 Margarine — 5 Mincemeat — 3 Chicken Cutlet — 1 Salmon Cutlet — 1 Sage and Onion Savoury and Stuffing — 1 Parsley and Thyme Savoury and Stuffing — 1 Sausages 8 — Gin 1 4 Whisky — 3 Golden Raising Powder — 1 Desiccated Coconut — 1 36 Certain samples were found to be inferior or adulterated, and there follows details of the action taken in each case:— article result of analysis action taken Rice Contained 1.3% lentils. Supplies withdrawn. Manufacturers' explanation accepted. Sponge Mix Deficiency in whole egg content compared with standard recipe for Sponge Mix. There being no legal standard, the Manufacturers attention was informally drawn to this matter and their co-operation obtained to increase egg content. Meringue Powder Contained 60% of starch, undeclared. Manufacturer's explanation of error accepted. Cheese Spread (2 cases) Deficient in fat content. The deficiency was very slight and the attention of the Manufacturers was drawn thereto. Pancake and Yorkshire Pudding Mixture Deficient in egg content. Labelling not justified. Manufacturers were requested, and agreed, to alter the type of label used. Processed Gruyfcre Cheese Excessive moisture content. Due to faulty packing. The whole consignment was withdrawn. Processed Gruy ire Cheese Deficient in fat content. The deficiency was very slight and the attention of the Manufacturers was drawn thereto. Dirty Milk Bottles (3) The bottles contained foreign matter. Warning letters sent to the Dairymen concerned. Pasteurised Processed Cheese Deficient in fat. Incorrectly labelled as processed cheese. The Manufacturers' attention having been drawn to the matter, it was agreed that the product should in future be labelled as Cheese Spread. Creamed Rice Labelling incorrect in that sample contained a deficient amount of full cream milk. The Manufacturers agreed substantially to increase the full cream content of the milk. Non-Poison Chlorodyne Should not be described as Chlorodyne for reason that it does not agree with the constituents of chlorodyne as defined in the British Pharmacopoeia. Matter referred to British Pharmaceutical Society. Obtained the co-operation of the Manufacturers, who agreed to withdraw the product from the market. Ground Sweet Almonds Probably consisted of Peach kernels. Further action unable to be taken, as whole of consignment from which sample was taken had been sold. Matter brought to the attention of the Importers. Salmon Cutleis Not Salmon: probably Coal fish. Processors informed, who agreed to alter labelling of the product. Margarine (with 10% butter) Labelling incorrect in that it only contained 4.8% butter. Subsequent samples were found to be satisfactory. Pork Sausages Adulterated. Deficient in meat content. Legal proceedings instituted. Manufacturers fined £10 with £10 10s. Od. costs. Pork Sausages Adulterated. Deficient in meat content. Manufacturers fined £5 and £10 10s. Od. costs. Pork Sausages (2 cases) Inferior. Slightly deficient in meat content. Manufacturers' attention drawn thereto. Gin Slightly deficient in proof spirit. Further formal sample proved to be satisfactory. 37 Ice Cream Sampling. Fifty-one samples of Ice Cream were examined during the year. No pathogenic organisms were isolated from the samples. Four of the samples proved to be unsatisfactory in that they showed a degree of contamination. This does not mean that the ice cream was unfit for consumption, but rather is an indication that all possible care in the use of sterile equipment had not been taken. The receipt of such a result brings about a very close check on the manufacturer's premises, and further sampling until a satisfactory result is obtained. Disinfection. The Council undertakes, free of charge, the disinfection of rooms, articles of clothing and bedding, after cases of Tuberculosis and occasionally other Infectious Diseases. Many requests are received from residents for the steam disinfection of bedding, etc., after cases of illness other than infectious disease. The requests are met, but a charge is made for the service. During 1955 28 applications were received and accounts rendered for £33 13s. 6d. During the year 143 Library books were collected from homes where infectious disease had occurred, disinfected and returned to the Library of origin. Drainage. As will be seen from the Table of nuisances remedied, 221 instances of choked drains were discovered during the year. A great many of these chokages related to public sewers, i.e. drains receiving wastes of two or more houses. The Council accepts as a legal responsibility the clearance of public sewers and the work is undertaken without any charge being made to the owners or occupiers of the properties. Of the 280 cases discovered, however, 181 related to private drainage, and in these cases a charge is made for the work undertaken. Accounts were rendered for £113 6s. Od. for this work. The repair of combined drains is also undertaken by the Council in accordance with statute, the cost of works being recovered from the owners of the properties concerned. Water Supply. The water supply of the area has been satisfactory in quality and quantity, the Metropolitan Water Board supplying all properties in the area by main. Bacteriological examination has been regular, 36 samples being taken during the year. All proved to be satisfactory. Moveable Dwellings. Fifteen families occupied moveable dwellings under licence from the Council during 1955. Frequent inspections of the sites of the caravans were made and in no instance was a Public Health nuisance discovered. 38 Factories Act, 1937. Three hundred and ninety-two visits of inspection were made to factories in the area and the following nuisances were remedied following the service of Intimation Notices:— Want of cleanliness 4 Unsuitable or defective sanitary conveniences 36 Shops Acts. One hundred and twenty-seven visits were paid in connection with the Shops Acts. Mortuary. The administration of the Beckenham Mortuary is the responsibility of the Public Health Department, the Mortuary Attendant being a member of the Medical Officer's staff. During 1955 114 bodies were brought to the Mortuary, where postmortem examinations were conducted by a Home Office Pathologist. The Mortuary Attendant is responsible, under supervision, for the maintenance and cleanliness of the building, the reception and collection of bodies, assistance at Post-Mortems, and the preparation and arrangement of a Town Hall room for the purposes of Inquest. Charge is taken of any clothing or valuables found on deceased persons and next-of-kin are immediately informed. National Assistance Act, 1948. Burial and Cremation of Dead. Section 50 of this Act places responsibility on a local authority for the burial of persons who have died, or been found dead in their area, where it appears that no suitable arrangements for disposal have been made. During 1955 4 burials had thus to be arranged. In one case only was the Council able to recover the costs involved. This duty involves a considerable amount of work, as the Officers have to act as enquiry agents in their endeavours to trace the history of deceased persons and the possibility of surviving relatives. In the absence of any legitimate claimant to valuables or money found, the matter is referred to the Treasury Solicitor. 39 Rat and Mouse Infestation. The free service given for the extermination of rats and mice in domestic properties has continued throughout the year, and it has again been necessary to exercise continual care to control the nuisance which remains widespread. Eight hundred and seventy-seven complaints were received during the year. Included in the figures given are complaints relating to business premises, and altogether 85 such premises were serviced, and in these cases accounts were submitted for £126 2s. Od. There is no doubt that the service given is one which is particularly welcomed by the residential population. During 1955 the sewers of the Town have been baited and poisoned on two occasions, and I am able to report that the infestation below ground is still kept at a minimum. I wish to express my thanks to my colleagues who have worked with me so loyally during the year under review. G. A. WEBBER, Chief Sanitary Inspector. 40